Finger Injury

Symptoms

DEFINITION

• Injury the skin or nail of the finger
• Injury to a bone, muscle, joint or ligament of the finger

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Types of Injuries

• Abrasions or Scrapes: An area of superficial skin has been scraped off. Commonly occurs on the knuckles.
• Cuts and Scratches: Superficial cuts (scratches) only extend partially through the skin and rarely become infected.  Deep cuts (lacerations) go through the skin (dermis).
• Bruises: Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.
• Fractures (broken bones)
• Dislocations (bone out of joint)
• Jammed Finger: The end of a straightened finger or thumb receives a blow (usually from a ball). The ligaments and tendons of the finger are stretched and torn.
• Crushed Fingertip: This injury most often results from getting the finger smashed in a car door or from a heavy object falling on the finger (a hammer!). Usually the fingertip receives a few cuts, a blood blister or a bruise. Sometimes the nail is damaged. A fracture of the bone inside the fingertip can occasionally occur.
• Subungual Hematoma (blood under the fingernail): This medical term is applied when a blood clot forms under the fingernail. It is caused by a crush injury to the fingertip. Some subungual hematomas are only mildly painful and blood is typically under less than 50% of nailbed. Others can be severely painful and throbbing, and these may need the pressure released to relieve the pain. The pressure can be released by putting a small hole through the nail.  With larger subungual hematomas, the fingernail will usually fall off. A new nail will grow back in 6 to 12 weeks.
• Torn Nail: From catching it on something.

When are Stitches Needed?

• Any cut that is split open or gaping probably needs sutures (stitches). Cuts longer than 1/2 inch usually need sutures.
• A physician should evaluate any open wound that may need sutures regardless of the time that has passed since the initial injury.

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See More Appropriate Topic (instead of this one) If

• ANIMAL BITE to finger
• BURN of finger
• SPLINTER OR SLIVER in finger
• PUNCTURE WOUND to finger

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FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for a Sprain of the Finger:

• Remove any rings or jewelry from the injured finger.
• Tape the injured finger to the finger next to it (this is called a buddy splint).
• Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

FIRST AID Advice for Suspected Fracture or Dislocation of the Finger:

• Remove any rings or jewelry from the injured finger.
• Tape the injured finger to the finger next to it (this is called a buddy splint).
• Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

FIRST AID Advice for Transport of an Amputated Finger

:

• Briefly rinse amputated part with water (to remove any dirt).
• Place amputated part in plastic bag (to protect and keep clean).
• Place plastic bag containing part in a cup of ice water (to keep cool and preserve tissue).

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Major bleeding (actively bleeding or spurting) that can't be stopped
• Finger has been partially or completely amputated
• NOTE: For bleeding, see First Aid

Call Your Doctor Now (night or day) If

• You think you have a serious injury
• Injury looks like a dislocated joint (crooked or deformed)
• Bleeding that hasn't stopped after 10 minutes of direct pressure
• Cut or scrape is very deep (e.g., can see bone or tendons)
• Skin is split open or gaping and may need stitches
• Blood present under the nail is causing severe pain
• Fingernail is torn-off or partially torn from a crush injury or cut
• Dirt or grime in the wound is not removed after 15 minutes of scrubbing
• High pressure injection injury (e.g., from paint gun, usually work-related)
• Fingernail is completely torn off
• Base of fingernail has popped out from under skin fold
• Cut or scrape looks infected (redness, red streak or pus)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think you need to be seen
• Finger joint can't be opened (straightened) and closed (bent) completely
• Cut or scrape and it's been more than 10 years since last tetanus booster (5 years for dirty cuts and scrapes)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Injury interferes with work or school
• Injury and pain have not improved after 3 days
• Injury is still painful and swollen after 2 weeks

Self Care at Home If

• Minor finger injury and you don't think you need to be seen

Care at Home

HOME CARE ADVICE FOR MILD INJURIES OF FINGER

1. Treatment of Cuts, Scratches and Scrapes (abrasions):
   • Apply direct pressure for 10 minutes to stop any bleeding.
   • Wash the wound with soap and water for 5 minutes.
   • Scrub out any dirt gently with a washcloth.
   • Cut off any pieces of dead loose skin using fine scissors (clean scissors with rubbing alcohol before and after use).
   • Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
2. Treatment of Bruised Finger: Soak the finger in cold water for 20 minutes.
3. Treatment of Jammed Finger:
   • Caution - Be certain range of motion is normal (can bend and straighten each finger).
   • Soak the finger in cold water for 20 minutes.
   • If the pain is more than mild, protect it by "buddy-taping" it to the next finger
4. Treatment of Smashed or Crushed Fingertip:
   • Apply an ice bag to the area for 20 minutes.
   • Wash the finger with soap and water for 5 minutes.
   • Trim any small pieces of torn dead skin with a scissors cleaned with rubbing alcohol.
   • Cover any cuts with an antibiotic ointment and Band-Aid. Change daily.
5. Treatment of Subungual Hematoma (blood under the nail): Apply an ice bag to the area for 20 minutes.
6. Torn Nail (from catching it on something):
   • For a cracked nail without rough edges, leave it alone.
   • For a large flap of nail that is almost torn through, use a sterile scissors to cut it off along the line of the tear (Reason: pieces of nail will catch on objects and tear further).
   • Apply an antibiotic ointment and cover with a Band-Aid. Change daily.
   • After about 7 days, the nail bed should be covered by new skin and no longer hurt. It takes about 6-12 weeks for a fingernail to grow back completely.
7. Pain Medication:
   • For pain relief, take acetaminophen or ibuprofen.
   • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
   • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
   • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
   • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
   • CAUTION: Do not take acetaminophen if you have liver disease.
   • Read the package instructions thoroughly on all medications that you take.
8. Call Your Doctor If:
   • Cut or scrape looks infected (redness, red streak or pus)
   • Pain becomes severe
   • Pain does not improve after 3 days
   • Pain or swelling lasts more than 2 weeks
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

 

First Aid - Amputated Finger or Toe - Transport

• Step 1: Briefly rinse amputated part with water (to remove any dirt)
• Step 2: Place amputated part in plastic bag (to protect and keep clean)
• Step 3: Place plastic bag containing the part in a container of ice (to keep cool and preserve tissue).

Note: Take patient and amputated part to emergency department immediately.

First Aid - Bleeding Finger

• Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth.

First Aid - Removing a Splinter

You can remove splinters, larger slivers, and thorns with a needle and tweezers. Check the tweezers beforehand to be certain the ends (pickups) meet exactly. (If they do not, bend them.) Sterilize the tools with rubbing alcohol or a flame.

Clean the skin surrounding the sliver briefly with rubbing alcohol before trying to remove it. Be careful not to push the splinter in deeper. If you don't have rubbing alcohol, use soap and water, but don't soak the area if FB is wood (Reason: can cause swelling of the splinter).

Remove the splinter:

• Step 1: Use the needle to completely expose the large end of the sliver. Use good lighting. A magnifying glass may help.
• Step 2: Then grasp the end firmly with the tweezers and pull it out at the same angle that it went in. Getting a good grip the first time is especially important with slivers that go in perpendicular to the skin or those trapped under the fingernail.

First Aid - Removing a Fishhook

This is method of fishhook removal is sometimes referred to as the Advance and Cut Method.

There are four steps in removing a fishhook using this this method:

1. Step 1. Using pliers (or needle drivers) firmly grasp the hook.
2. Step 2. Push (advance) the hook until the tip of the hook pops out through the skin.
3. Step 3. Cut off the tip of the hook (and the barb).
4. Step 4. Pull (back out) the hook out.

Important Note:

• These instructions assume that you can not get into see a doctor right away. In most circumstances it is best to have a physician (or other licensed health care provider) remove an embedded fishhook.
• The hook in this drawing has only a single barb at the tip, and thus the tip of the hook (with the barb) can be cut off and the hook pulled backwards through the skin.
• Some hooks can have more than one barb along the shaft of the hook. In such cases, it is better to cut off the ring at the bottom of the hook and push the hook all of the way through the skin.